Provider Demographics
NPI:1932272358
Name:SERENITY HEALTH CARE, INC.
Entity Type:Organization
Organization Name:SERENITY HEALTH CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:HELEN
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:626-914-8481
Mailing Address - Street 1:1305 W ARROW HWY
Mailing Address - Street 2:
Mailing Address - City:SAN DIMAS
Mailing Address - State:CA
Mailing Address - Zip Code:91773-2336
Mailing Address - Country:US
Mailing Address - Phone:626-914-8481
Mailing Address - Fax:626-914-6812
Practice Address - Street 1:1305 W ARROW HWY
Practice Address - Street 2:
Practice Address - City:SAN DIMAS
Practice Address - State:CA
Practice Address - Zip Code:91773-2336
Practice Address - Country:US
Practice Address - Phone:626-914-8481
Practice Address - Fax:626-914-6812
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA05-8282Medicare ID - Type UnspecifiedPROVIDER NUMBER